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Adverse impact of tumor deposits in lymph node negative rectal cancer — a national cohort study

Lundström, Simon LU orcid ; Agger, Erik LU orcid ; Lydrup, Marie-Louise LU ; Jörgren, Fredrik LU and Buchwald, Pamela LU (2023) In International Journal of Colorectal Disease 38. p.1-10
Abstract
Purpose This study aimed to investigate the prognostic effect of tumor deposits (TDs) in lymph node negative rectal cancer. Methods Patients who had undergone surgery for rectal cancer with curative intention between 2011 and 2014 were extracted from the Swedish Colorectal Cancer Registry. Patients with positive lymph nodes, undisclosed TD status, stage IV disease, non-radical resections, or any outcome (local recurrence (LR), distant metastasis (DM) or mortality) within 90 days after surgery were excluded. TDs status was based on histopathological reports. Cox-regression analyses were used to examine the prognostic impact of TDs on LR, DM, and overall survival (OS) in lymph node–negative rectal cancer. Results A total of 5455 patients... (More)
Purpose This study aimed to investigate the prognostic effect of tumor deposits (TDs) in lymph node negative rectal cancer. Methods Patients who had undergone surgery for rectal cancer with curative intention between 2011 and 2014 were extracted from the Swedish Colorectal Cancer Registry. Patients with positive lymph nodes, undisclosed TD status, stage IV disease, non-radical resections, or any outcome (local recurrence (LR), distant metastasis (DM) or mortality) within 90 days after surgery were excluded. TDs status was based on histopathological reports. Cox-regression analyses were used to examine the prognostic impact of TDs on LR, DM, and overall survival (OS) in lymph node–negative rectal cancer. Results A total of 5455 patients were assessed for inclusion of which 2667 patients were analyzed, with TDs present in 158 patients. TD-positive patients had a lower 5-year DM-free survival (72.8%, p < 0.0001) and 5-year overall survival (75.9%, p = 0.016), but not 5-year LR-free survival (97.6%) compared to TD-negative patients (90.2%, 83.1% and 95.6%, respectively). In multivariable regression analysis, TDs increased the risk of DM [HR 4.06, 95% CI 2.72–6.06, p < 0.001] and reduced the OS [HR 1.83, 95% CI 1.35–2.48, p < 0.001]. For LR, only univariable regression analysis was performed which showed no increased risk of LR [HR 1.88, 95% CI 0.86–4.11, p = 0.11]. Conclusion TDs are a negative predictor of DM and OS in lymph node–negative rectal cancer and could be taken into consideration when planning adjuvant treatment. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Colorectal Disease
volume
38
article number
66
pages
1 - 10
publisher
Springer
external identifiers
  • pmid:36897408
  • scopus:85149974106
ISSN
1432-1262
DOI
10.1007/s00384-023-04365-1
project
Tumor deposits in rectal cancer: from diagnostics to staging and treatment
language
English
LU publication?
yes
id
fc04cb52-7db8-4d7d-950f-11a99961566a
date added to LUP
2023-03-10 15:39:29
date last changed
2023-09-12 11:34:34
@article{fc04cb52-7db8-4d7d-950f-11a99961566a,
  abstract     = {{Purpose This study aimed to investigate the prognostic effect of tumor deposits (TDs) in lymph node negative rectal cancer. Methods Patients who had undergone surgery for rectal cancer with curative intention between 2011 and 2014 were extracted from the Swedish Colorectal Cancer Registry. Patients with positive lymph nodes, undisclosed TD status, stage IV disease, non-radical resections, or any outcome (local recurrence (LR), distant metastasis (DM) or mortality) within 90 days after surgery were excluded. TDs status was based on histopathological reports. Cox-regression analyses were used to examine the prognostic impact of TDs on LR, DM, and overall survival (OS) in lymph node–negative rectal cancer. Results A total of 5455 patients were assessed for inclusion of which 2667 patients were analyzed, with TDs present in 158 patients. TD-positive patients had a lower 5-year DM-free survival (72.8%, p &lt; 0.0001) and 5-year overall survival (75.9%, p = 0.016), but not 5-year LR-free survival (97.6%) compared to TD-negative patients (90.2%, 83.1% and 95.6%, respectively). In multivariable regression analysis, TDs increased the risk of DM [HR 4.06, 95% CI 2.72–6.06, p &lt; 0.001] and reduced the OS [HR 1.83, 95% CI 1.35–2.48, p &lt; 0.001]. For LR, only univariable regression analysis was performed which showed no increased risk of LR [HR 1.88, 95% CI 0.86–4.11, p = 0.11]. Conclusion TDs are a negative predictor of DM and OS in lymph node–negative rectal cancer and could be taken into consideration when planning adjuvant treatment.}},
  author       = {{Lundström, Simon and Agger, Erik and Lydrup, Marie-Louise and Jörgren, Fredrik and Buchwald, Pamela}},
  issn         = {{1432-1262}},
  language     = {{eng}},
  month        = {{03}},
  pages        = {{1--10}},
  publisher    = {{Springer}},
  series       = {{International Journal of Colorectal Disease}},
  title        = {{Adverse impact of tumor deposits in lymph node negative rectal cancer — a national cohort study}},
  url          = {{http://dx.doi.org/10.1007/s00384-023-04365-1}},
  doi          = {{10.1007/s00384-023-04365-1}},
  volume       = {{38}},
  year         = {{2023}},
}